Daiichi Sankyo is one of several pharmaceutical companies to employ key account managers who target sales pitches to executives at large hospital systems and independent delivery networks rather than to individual prescribers.

Daiichi Sankyo now employs 10 key account managers who market drugs to 70 health systems, Erin Curcio, director of payer marketing for organized health systems at Daiichi Sankyo, said during a panel discussion at the annual ePharma Summit conference in New York City.

The new sales model relies on key account managers rather than reps and is becoming more common as “access to prescribers is getting more challenging” and as “more centralized decision making” is occurring, Curcio said.

But that new model is not yet necessary at all IDNs and large hospital systems. If formulary decisions aren't being made at the parent company level, traditional marketing involving a sales representative and a prescriber continues to provide value, she added. Still, Curcio said she expects more hospitals and IDNs to start making those decisions at the system level.

As hospital systems get bigger, they are changing the way that clinicians and pharmaceutical reps interact and in some cases which drugs physicians employed by or affiliated with their organizations prescribe.

In addition, some hospitals and academic medical centers are implementing stricter conflict-of-interest policies. At least nine medical schools in 2014 forbade site access to pharmaceutical reps or established policies that prevent them from marketing to clinicians, according to an annual scorecard published in 2014 by the American Medical Student Association. This is up from two medical schools that had such policies in 2012.

About 40% of physicians affiliated with integrated health networks in 2014 said they are not allowed to see sales reps, a percentage that increased by 17% in one year, according to a survey released last year by Capgemini Consulting.

For their part, pharma companies have not always been open about just how their sales teams engage with hospitalists. Out of 27 pharma companies contacted by an MM&M reporter last year for an article on this topic, 12 declined to be interviewed and 14 were not responsive. Just one accepted, only to later cancel the interview.

“The lack of response could be indicative of many things,” speculated the article, which documented the rising prevalence of the hospitalist profession. Among the reasons: a worry that “a somewhat hostile target audience is not buying what they are selling—that [these companies] haven't cracked the hospital code.”

A consultant who spoke with MM&M for the story added, “My sense is that an awful lot of pharma still does not prioritize the hospitalist.”